Acute spinal cord injury
|
|
- Jack Rose
- 5 years ago
- Views:
Transcription
1 Acute spinal cord injury Thakul Oearsakul Songklanagarind hospital Hat Yai Songkhla Introduction New SCI cases Approximately per population Common causes of traumatic SCI :Motor vehicle accidents 45% : fall 20% : sports 15% : violence 15% : miscellaneous 5% 1!
2 Introduction The most common site : cervical region 50-64% (incomplete:complete 2:1) : the lumbar region (conus medullaris or cauda equina) 20-24% : thoracic cord 17-19% Introduction Undiagnosed or suboptimally managed spine injury can result in a neurologic deficit and permanent impair a pts function. 2!
3 introduction Functional motor recovery 3% ( complete injury within 24 Hrs) No functional motor recovery after Hrs. Incomplete cord injury has a good prognosis Sacral sparing is important Acute care phases Diagnosis and acute management 1. Initial assessment and immobilization 2. Medical management 3. Anatomical alignment 4. Radiologic diagnosis 5. Surgical decompression 6. stabilization 3!
4 Goal of acute care phases Provide initial cardiopulmonary management, immobilization and careful transportation. Enhence blood flow to the injured SCI Prevent reinjury to the injured SCI by mechanically stabilizing the unstable Fx The first care: Initial assessment A high index of suspicion A protocol-based procedure for splinting and immobilization ATLS 4!
5 The second care: medical support Maintenance of an airway and adequate ventilation Early intubation of the pts with airway compromise In-line manual traction or awake fiberoptic intubation MANAGEMENT 0. PRE-HOSPITAL (BASIC LIFE SUPPORT, SPINAL IMMOBIILIZATION, TRANSFER) 5!
6 ! Management! How do I protect the spine? - Immobilize entire patient on long spine board with proper padding - Apply semirigid collar - Protection is priority:detection is secondary - Remove spine board as soon as possible and logroll patient - Pressure sores occur early in unconscious or paralyzed patients PRIMARY SURVEY AND RESUSCITATION! Airway and c-spine protection Breathing (above C4) Pitfall : no c-spine detection! 6!
7 Airway maintenance techniques 1. Chin-lift 2. Jaw thrust The second care: medical support! Circulation :hypovolumic shock :neurogenic shock (above T6)! Treatment :fluid resuscitation :vasopressor drug :maintain blood pressure(map>85 mmhg*5 day) :atropine! 7!
8 The second care: medical support C: FLUID RESUSCITATION AND MONITORING 1. CVP MONITORING 2. URINARY CATHETER : DURING THE PRIMARY SERVEY & RESUSCITATION : MONITOR URINE OUT PUT & PREVENT BLADDER DISTENTION 3. GASTRIC CATHETER : PREVENT GASTRIC DISTENTION AND ASPIRATION MANAGEMENT (CONT.) E; modified log roll ;hypothermia (above T8) 8!
9 MANAGEMENT (CONT.) SECONARY SURVEY spine detection Clinical Assessment NEUROLOGIC EVALUATION 1. MOTOR EVALUATION 2. SENSORY EVALUATION 3. REFLEX EVALUATION NOTE: severity and level of injury 9!
10 10!
11 CLINICAL ASSESSMENT (3) SPINAL CORD SYNDROMES * Bell s cruciate paralysis * Central cord syndrome * Anterior cord syndrome * Posterior cord syndrome * Brown-Sequard syndrome (best prognosis) * Conus medullaris syndrome Neurologic Status Neurologic level Most caudal level of motor / sensory function Motor and sensory may not be the same Sensory can vary on each side Bony level Site of vertebral column damage 11!
12 Sacral sparing! Bulbocavernosus reflex! 12!
13 Assess neurologic status (severity)! Spinal shock. ( neurogenic shock)! Complete cord Incomplete cord. (Sacral sparing)! Patient evaluation Neurological examination Spinal shock : Bulbocarvernosus reflex Sacral sparing : Perianal sensation Anal sphincter tone Motor power of toe flexor 13!
14 Assess neurologic status! motor! sensory! reflex! Spinal shock! Complete cord! Incomplete cord! -! -! -! -! -! +! +! +! +! 14!
15 Incomplete cord! 15!
16 The third care: Radiology 1. PLAIN FLIM * CROSS TABLE LATERAL CERVICAL VIEW * ANTERIOR - POSTERIOR VIEW * OPEN - MOUTH VIEW * SWIMMING VIEW * FLEXION - EXTENSION VIEW * ANTERO - POSTERIOR & LARERAL VIEW OF THORACIC, LUMBAR Magnetic Resonance Imaging (MRI)! Evaluation of spinal cord injury and soft tissue injury Persistant pain, worsening neurologic ft.! 16!
17 Adventages of MR imaging! Cause of neurological deficit :spinal cord injury :extra-axial injury (EDH,disc herniation) Presence of ligamentous injury : transverse lig. Pretraction MRI Neurological deterioration after traction and reduction. In many center,difficult to obtain within several Hrs. Rapid closed reduction is successful and safe.(sci) Waiting for MRI should not delay closed reduction(sci) Neurologically intact pt with CS dislocation : may be obtained pretraction MRI. 17!
18 Summary of clearing cervical spine! Asymptomatic: clinical exam Symptomatic: X-ray images :Neurological deficits :Obtunded :Alert, awake, Neurologically normal,but neck pain! Clinically clearing the cervical spine (asymptomatic patient)! After blunt polytrauma, the patient s cervical spine may be regarded as stable if: 1. Glasgow Coma Scale (GCS) = 15, and the patient is alert and orientated 2. No intoxicants or drugs have been consumed 3. No significant distracting injuries have occurred 4. No signs or symptoms on cervical examination: i) No midline tenderness or pain ii) Full range of active movement iii) No referable neurological deficit! The reliability and performance of these criteria requires judgement and strict application by the clinician! 18!
19 ! Guideline for Symptomatic patients! Alert, awake,neurologically normal, complaints of neck pain (ATLS (1997),EAST (2000)) :plain films and directed CT :if lower c-spine inadequate;swimmer or axial CT with reconstruction :if normal,removed collar :static F/E with pts sitting and voluntarily F/E :if F/E <30 degree,the collar should be replaced and repeat F/E in 2 wks Guideline for Symptomatic patients! Pts with neurological deficits EAST (2000) :plain films and directed CT :MRI! 19!
20 Guideline for Symptomatic patients! Altered mental status,and too young ATLS (1997) :plain films (AP,lateral,open mouth) :directed CT Not returned to normal within 2 days EAST(2000) :plain films and axial CT with saggital reconstruction occiput to C2 :directed CT :if normal,dynamic fluoroscopy F/E with static images! The fourth care: reestablish bony alignment Remove any direct mechanical compressive forces. Gardner-Wells tong or halo vest immobilization 20!
21 SPINAL IMMOBILIZATION SKULL TRACTION TONG ( GARDNER - WELLS TONG ) Adventage for : instability : realignment and stabilization Becareful :neuro exam and serial imaging when traction SKULL TRACTION TONG ( GARDNER - WELLS TONG ) Absolute contraindication * Occipitoatlantal dislocation (type II) * Concomitant open skull fractures 21!
22 22!
23 The fifth phase:surgical decompression Emergency or urgent Sx decompression Bilateral locked facets without reducing by traction (incomplete SCI) Almost all thoracic and lumbar Fx with neurological deficit require Sx decompression and/or internal stabilization (incomplete SCI) 23!
24 Surgical Goal Reduction of malalignment Decompression of the neural elements Restoration of spinal stability Timing of surgery 24!
25 Timing of surgery The sixth phase: mechanical stabilization Stability of the spinal column Prevent reinjury of the spinal cord from the unstable bony elements. Internal stabilization with hardware,external splinting 25!
26 The seventh phase : critical care Prevent stress ulcer Prevent deep venous thrombosis Effects of Spinal Cord Injury Inadequate ventilation Abdominal evaluation compromised Occult compartment syndrome 26!
27 Pharmacologic intervention Methylprednisolone! Blunt injury only Spinal cord injury Injury less then 8 hrs Start within 8 hours of injury : 30 mg/kg over 15 min : 5.4 mg/kg over next.23 hrs if started within 3 hrs of injury.48 hrs if started within 3 to 8 hrs after injury Complication : ( 48hrs) severe sepsis and pneumonia! 27!
28 Thank you! Thank you! 28!
Common fracture & dislocation of the cervical spine. Theerachai Apivatthakakul Department of Orthopaedic Chiangmai University
Common fracture & dislocation of the cervical spine Theerachai Apivatthakakul Department of Orthopaedic Chiangmai University Objective Anatomy Mechanism and type of injury PE.and radiographic evaluation
More informationSpinal Cord Injuries: The Basics. Kadre Sneddon POS Rounds October 1, 2003
Spinal Cord Injuries: The Basics Kadre Sneddon POS Rounds October 1, 2003 Anatomy Dorsal columntouch, vibration Corticospinal tract- UMN Anterior horn-lmn Spinothalamic tractpain, temperature (contralateral)
More informationSpinal Trauma. Dr T G Kruger
Spinal Trauma Dr T G Kruger Epidemiology Spine injury in 6% of trauma patients Multiple levels involved in 20% of cases 80% of spinal cord injury patients have concurrent other system injuries 41% have
More informationSPINE EVALUATION AND CLEARANCE Basic Principles
SPINE EVALUATION AND CLEARANCE Basic Principles General 1. Entire spine is immobilized during primary survey. 2. Radiographic clearance of the spine is not required before emergent surgical procedures.
More information11. Spinal cord injury
11. Spinal cord injury Introduction Always think spinal (vertebral) and/or spinal cord injury (SCI) in children with trauma. Remember SCIWORA cord injury may be present without abnormalities on routine
More informationSCIWORA Rozlyn McTeer BSN, RN, CEN Pediatric Trauma Coordinator Trauma Services OBJECTIVES DEFINITION 11/8/2017. Identify SCIWORA.
SCIWORA Rozlyn McTeer BSN, RN, CEN Pediatric Trauma Coordinator Trauma Services Identify SCIWORA. OBJECTIVES Identify the population at risk. To identify anatomic and physiologic reasons for SCIWORA. To
More informationIndications for cervical spine immobilisation: -
Paediatric Trauma Cervical Spine Guidelines UHW Traumatic injuries of the cervical spine (C-spine) are uncommon in children. However, it is safer assume there is a cervical spine injury until examination
More informationNorth West London Trauma Network Spinal Pathway and Protocols
North West London Trauma Network Spinal Pathway and Protocols 1. Spinal Clearance in the Trauma Patient Inclusions: All trauma patients who are not alert and orientated, unable to cooperate (including
More informationSpine Trauma- Part B
Spine Trauma- Part B Cervical Spine Injuries Atlanto- Occipital Dislocation Hyperextension and distraction mechanism Down s syndrome, RA more susceptible Asymmetric lateral masses on odontoid view Widened
More informationTALK TRAUMA Clearing the C-Spine. David Ouellette
TALK TRAUMA 2011 Clearing the C-Spine David Ouellette Case #1 - Mother / Daughter MVC 34 y/o female Dangerous mechanism CHI Mumbling incoherently Femur # - distracting injury ETOH - 22 9 y/o female Dangerous
More informationEvaluation for spinal injuries among unconscious victims of blunt polytrauma: a management guideline for intensive care
Evaluation for spinal injuries among unconscious victims of blunt polytrauma: a management guideline for intensive care Background 1.0 There is lack of consistency among clinicians when managing critically
More information1. Spinal cord injury mild flexion-extension whiplash ~ complete transection with permanent quadriplegia
Wk 5. Management of Clients with Neurologic Trauma 1. Spinal cord injury mild flexion-extension whiplash ~ complete transection with permanent quadriplegia most common in cervical, lower thoracic-upper
More informationIntroduction to Emergency Medical Care 1
Introduction to Emergency Medical Care 1 OBJECTIVES 31.1 Define key terms introduced in this chapter. Slides 13 15, 17, 19, 28 31.2 Describe the components and function of the nervous system and the anatomy
More informationSelective Spine Assessment & Spinal Motion Restriction
Selective Spine Assessment & Spinal Motion Restriction Supersedes: 02-09-15 Effective: 10-20-15 Spinal cord injury may be the result of direct blunt and/or penetrating trauma, compression forces (axial
More informationWounds and Injuries of the Spinal Column and Cord
Wounds and Injuries of the Spinal Column and Cord Chapter 20 Wounds and Injuries of the Spinal Column and Cord Introduction Combat injuries of the spinal column, with or without associated spinal cord
More informationMULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
EPC Ch 24 Quiz w-key Name MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 1) Which of the following best explains the presentation and prognosis of
More informationSubaxial Cervical Spine Trauma
Subaxial Cervical Spine Trauma Pooria Salari, MD Assistant Professor Of Orthopaedics Department of Orthopaedic Surgery St. Louis University School of Medicine St. Louis, Missouri, USA Initial Evaluation
More informationCERVICAL SPINE CLEARANCE
DISCLAIMER: These guidelines were prepared by the Department of Surgical Education, Orlando Regional Medical Center. They are intended to serve as a general statement regarding appropriate patient care
More informationSir William Asher ANATOMY
SPINAL CORD INJURY BASICS RELATED TO LIFE CARE PLANNING Lesson 1 Sir William Asher Picture the pathetic patient lying long abed, the urine leaking from his distended bladder, the lime draining from his
More informationPre-hospital Response to Trauma and Brain Injury. Hans Notenboom, M.D. Asst. Medical Director Sacred Heart Medical Center
Pre-hospital Response to Trauma and Brain Injury Hans Notenboom, M.D. Asst. Medical Director Sacred Heart Medical Center Traumatic Brain Injury is Common 235,000 Americans hospitalized for non-fatal TBI
More informationTime Equals Neurons - Spinal Cord Injury Management in the first 4 Hours
Time Equals Neurons - Spinal Cord Injury Management in the first 4 Hours William D. Whetstone M.D. Clinical Professor UCSF Department of Emergency Medicine SFGH ED Center for Neuro-Critical Emergencies
More informationDetermination of Cervical Spine Stability in Trauma Patients (Update of the 1997 EAST Cervical Spine Clearance Document)
1 Determination of Cervical Spine Stability in Trauma Patients (Update of the 1997 EAST Cervical Spine Clearance Document) Cervical Spine Clearance Committee Donald Marion Robert Domeier C. Michael Dunham
More informationOverview. Overview. Chapter 30. Injuries to the Head and Spine 9/11/2012. Review of the Nervous and Skeletal Systems. Devices for Immobilization
Chapter 30 Injuries to the Head and Spine Slide 1 Overview Review of the Nervous and Skeletal Systems The Nervous System The Skeletal System Devices for Immobilization Cervical Spine Short Backboards Long
More informationTraumatic Spinal Cord Injury. 39 th CANP Annual Educational Conference March 18 th, :00pm-6:15pm Carl Wherry, ACNP-bc Amanda Severson, ACNP-bc
Traumatic Spinal Cord Injury 39 th CANP Annual Educational Conference March 18 th, 2016 5:00pm-6:15pm Carl Wherry, ACNP-bc Amanda Severson, ACNP-bc Disclosures No conflicts of interest to disclose. Introduction
More informationSubaxial Cervical Spine Trauma Dr Hesarikia BUMS
Subaxial Cervical Spine Trauma Dr. Hesarikia BUMS Subaxial Cervical Spine From C3-C7 ROM Majority of cervical flexion Lateral bending Approximately 50% rotation Ligamentous Anatomy Anterior ALL, PLL, intervertebral
More informationThoracic and Lumbar Spine Fractures and Dislocations: Assessment and Classification
Thoracic and Lumbar Spine Fractures and Dislocations: Assessment and Classification Mark L Prasarn MD University of Texas Dept of Orthopaedic Surgery Houston, Texas Updated 7/2016 Anatomy of the Spine
More informationHeidi Lako-Adamson, MD, NRP, FAEMS FM Ambulance and Sanford EMS Education Medical Director
Heidi Lako-Adamson, MD, NRP, FAEMS FM Ambulance and Sanford EMS Education Medical Director Spinal cord injury statistics. Definition of spinal motion restriction. Difference between spinal motion restriction
More informationChapter 32. Objectives. Objectives 01/09/2013. Spinal Column and Spinal Cord Trauma
Chapter 32 Spinal Column and Spinal Cord Trauma Prehospital Emergency Care, Ninth Edition Joseph J. Mistovich Keith J. Karren Copyright 2010 by Pearson Education, Inc. All rights reserved. Objectives 1.
More informationSUBAXIAL CERVICAL SPINE TRAUMA- DIAGNOSIS AND MANAGEMENT
SUBAXIAL CERVICAL SPINE TRAUMA- DIAGNOSIS AND MANAGEMENT 1 Anatomy 3 columns- Anterior, middle and Posterior Anterior- ALL, Anterior 2/3 rd body & disc. Middle- Posterior 1/3 rd of body & disc, PLL Posterior-
More informationChapter 24 Spinal Trauma Introduction to Spinal Injuries (1 of 2) Annually 15,000 permanent spinal cord injuries Commonly men years old
1 2 3 4 5 6 7 Chapter 24 Spinal Trauma Introduction to Spinal Injuries (1 of 2) Annually 15,000 permanent spinal cord injuries Commonly men 16-30 years old Mechanism of Injury: Vehicle crashes: 48% : 21%
More informationIntroduction. Objectives C-Spine: Where Are We Now? NAEMSP Medical Director Course 1/9/2013
NAEMSP Medical Director Course 1/9/2013 Objectives C-Spine: Where Are We Now? Robert M. Domeier, MD EMS Medical Director Washtenaw/Livingston Medical Control Authority Department of Emergency Medicine
More informationShepherd Center: A Catastrophic Care Hospital. The Jane Woodruff Pavilion
Shepherd Center: A Catastrophic Care Hospital The Jane Woodruff Pavilion Acute Management of SCI & Prevention of Secondary Complications Joycelyn Craig, BSN, RN, CRRN SCI Nurse Education Manager FACTS
More informationSubaxial Cervical Spine Trauma. Introduction. Anatomic Considerations 7/23/2018
Subaxial Cervical Spine Trauma Sheyan J. Armaghani, MD Florida Orthopedic Institute Assistant Professor USF Dept of Orthopedics Introduction Trauma to the cervical spine accounts for 5 of all spine injuries
More informationThorasic and lumbar spinal injury. Dr.Abrisham
Thorasic and lumbar spinal injury Dr.Abrisham Goal : alignment Stability Preserve neuologic function early mobilization Incidence: most site is thoraco lumbar 50% T 11 to L 1 30% L 2 to L 5 Motor vehicle
More informationSPINAL CORD INJURIES DR. F. DE V. THERON MUELMED/PAH HOSPITAL SPINAL UNIT 2012
SPINAL CORD INJURIES DR. F. DE V. THERON MUELMED/PAH HOSPITAL SPINAL UNIT 2012 INTRODUCTION Mortal condition recognised since antiquity First described in the Edwin Smith papyrus 2500BC An ailment not
More informationFractures of the thoracic and lumbar spine and thoracolumbar transition
Most spinal column injuries occur in the thoracolumbar transition, the area between the lower thoracic spine and the upper lumbar spine; over half of all vertebral fractures involve the 12 th thoracic
More informationFractures of the Thoracic and Lumbar Spine
A spinal fracture is a serious injury. Nader M. Hebela, MD Fellow of the American Academy of Orthopaedic Surgeons http://orthodoc.aaos.org/hebela Cleveland Clinic Abu Dhabi Cleveland Clinic Abu Dhabi Neurological
More informationVAriation. Orthotics and Me (?surgeons) Greg Etherington Spine Surgeon. Orthopaedic & Neurosurgery backgrounds. Subspeciality training
Orthotics and Me (?surgeons) Greg Etherington Spine Surgeon Orthopaedic & Neurosurgery backgrounds Subspeciality training spine, upper limb, trauma, pelvis. What do you do in spine? Lumbar Cervical Trauma
More informationSpinal injury. Structure of the spine
Spinal injury Structure of the spine Some understanding of the structure of the spine (spinal column) and the spinal cord is important as it helps your Neurosurgeon explain about the part of the spine
More informationSPINAL CORD INJURY-GSW
SPINAL CORD INJURY-GSW Wayne Cheng, MD Bones and Spine 1 EPIDEMIOLOGY-mechanism Most common cause of traumatic cord inj.: #1 MVA (45%) #2 Fall (22%) #3 Violence (16%) #4 Sports (13%) After 1990, Gsw now
More informationHIGH LEVEL - Science
Learning Outcomes HIGH LEVEL - Science Describe the structure and function of the back and spine (8a) Outline the functional anatomy and physiology of the spinal cord and peripheral nerves (8a) Describe
More informationInjuries to the Head and Spine
Injuries to the Head and Spine Anatomy Review Skull Protects the brain Made up of several bones with seam like sutures Regions of the scalp-frontal, occipital, parietal, temporal Bones of face Orbits Mandible
More informationSpine and Spinal Cord Injury in Children
Spine and Spinal Cord Injury in Children S. Danielle Brown, MS, RN, CNRN, SCRN Director, Research Coordination and Education Barrow Neurological Institute at Phoenix Children s Hospital Introduction Trauma
More informationUpper Cervical Spine - Occult Injury and Trigger for CT Exam
Upper Cervical Spine - Occult Injury and Trigger for CT Exam Main Menu Introduction Clinical clearance of C-SpineC Radiographic evaluation Norms for C-spineC Triggers for CT exam: Odontoid Lateral view
More informationOutline. Epidemiology Indications for C-spine imaging Modalities Interpretation Types of fractures
C-Spine Plain Films Outline Epidemiology Indications for C-spine imaging Modalities Interpretation Types of fractures Epidemiology 7000-10000 c-spine injuries treated each year Additional 5000 die at the
More informationCervical Spine Injury Guidelines
6/15/2018 Cervical Spine Injury Guidelines Benjamin Oshlag, MD, CAQSM Assistant Professor of Emergency Medicine Assistant Professor of Sports Medicine Columbia University Medical Center Nothing to Disclose
More informationShenandoah Co. Fire & Rescue. Injuries to. and Spine. December EMS Training Bill Streett Training Section Chief
Shenandoah Co. Fire & Rescue Injuries to the Head and Spine December EMS Training Bill Streett Training Section Chief C.E. Card Information BLS Providers 2 Cards / Provider Category 1 Course # Blank Topic#
More informationPhysical and Radiographic Examination of the Spine
Physical and Radiographic Examination of the Spine Christopher M. Bono, MD Assistant Professor, Department of Orthopaedic Surgery Boston University School of Medicine, Boston Medical Center, Boston, MA
More informationว ทยาการความก าวหน าในการร กษาผ ป วยบาดเจ บ กระด กส นหล งและไขส นหล ง. Piyawat Bintachitt, MD.
ว ทยาการความก าวหน าในการร กษาผ ป วยบาดเจ บ กระด กส นหล งและไขส นหล ง Piyawat Bintachitt, MD. Thank you Outline Pathophysiology Neurological classification Imaging Airway management Cardiovascular management
More information102 Results RESULTS. Age Mean=S.D Range 42= years -84 years Number % <30 years years >50 years
102 Results RESULTS A total of 50 cases were studied 39 males and 11females.Their age ranged between 16 years and 84 years (mean 42years). T1 and T2WI were acquired for all cases in sagittal and axial
More informationSPINAL IMMOBILIZATION
Spinal Immobilization Decision Assessment Recent studies have shown an increase in mortality for patients with isolated penetrating trauma who are spinally immobilized. Therefore spinal immobilization
More informationGillian Wooldridge, DO Houston Methodist Willowbrook Hospital Primary Care Sports Medicine Fellowship May 3, 2018
Gillian Wooldridge, DO Houston Methodist Willowbrook Hospital Primary Care Sports Medicine Fellowship May 3, 2018 Disclosures Neither I nor any family members have financial disclosures Special thanks
More informationMalignant Spinal cord Compression. Dr. Thiru Thirukkumaran Palliative Care Services - Northwest Tasmania
Malignant Spinal cord Compression Dr. Thiru Thirukkumaran Palliative Care Services - Northwest Tasmania Background Statistics of SCC -1 Incidence of SCC Vertebral body metastases 85 % Para-vertebral (Lymphoma)
More informationChapter 32. Injuries to the Spine by Pearson Education, Inc. Upper Saddle River, New Jersey
Chapter Injuries to the Spine Topics Anatomy and physiology of the spine Spinal injuries Guidelines for immobilization Special considerations Enrichment Introduction Injuries to the spine are among the
More information3/10/17 Spinal a Injury 1
Spinal Injury 1 'Paralysed' Watmough vows he'll have the backbone for Game Two after treatment for neck injury Watmough will have cortisone injected into his spine this morning to speed up the recovery
More informationAcute Care of Spinal Cord Injury. Meghan Smith, RN, PA-C
Acute Care of Spinal Cord Injury Meghan Smith, RN, PA-C Physician Assistant, Neuro Surgical, Trauma Services, Intermountain Medical Center, Intermountain Healthcare; Salt Lake City, Utah Objectives: Discuss
More informationEMS Spinal Assessment and Precautions
EMS Spinal Assessment and Precautions Adapted from a presentation prepared by Chelsea C. White IV, MD, NREMT-P Medical Director, Bernalillo County Fire Department Robert M. Domeier, MD, EMS Medical Director,
More informationATLS: Initial Assessment and Management. SAUSHEC Medical Student Lecture Series
ATLS: Initial Assessment and Management SAUSHEC Medical Student Lecture Series Objectives Identify sequence of priorities in assessing the multiply injured patient Apply principles outlined in primary
More informationEmergency Room Resuscitation of the Unstable Trauma Patient
Emergency Room Resuscitation of the Unstable Trauma Patient Goals of trauma resuscitation Maintain: Systemic oxygenation Systemic perfusion Neurologic function Approach to unstable trauma patient Primary
More informationMEDICAL CONTROL POLICY STATEMENT/ADVISORY. Re: Spinal Injury Assessment & Spinal Precautions Procedure
MEDICAL CONTROL POLICY STATEMENT/ADVISORY No. 2015-01 Date: January 20, 2015 Re: Spinal Injury Assessment & Spinal Precautions Procedure Office of the Medical Director Noel Wagner, MD, NREMT-P 1000 Houghton
More informationPRACTICE GUIDELINE. DEFINITIONS: Mild head injury: Glasgow Coma Scale* (GCS) score Moderate head injury: GCS 9-12 Severe head injury: GCS 3-8
PRACTICE GUIDELINE Effective Date: 9-1-2012 Manual Reference: Deaconess Trauma Services TITLE: TRAUMATIC BRAIN INJURY GUIDELINE OBJECTIVE: To provide practice management guidelines for traumatic brain
More informationfactor for identifying unstable thoracolumbar fractures. There are clinical and radiological criteria
NMJ-Vol :2/ Issue:1/ Jan June 2013 Case Report Medical Sciences Progressive subluxation of thoracic wedge compression fracture with unidentified PLC injury Dr.Thalluri.Gopala krishnaiah* Dr.Voleti.Surya
More informationInvolvement of the spine is common in rheumatoid. Incidence been reported to be 85% radiologically but only 30% have neurological signs and symptoms.
RHEUMATOID SPINE Involvement of the spine is common in rheumatoid. Incidence been reported to be 85% radiologically but only 30% have neurological signs and symptoms. When neurology is present it may manifest
More informationImaging of Cervical Spine Trauma
Imaging of Cervical Spine Trauma C Craig Blackmore, MD, MPH Professor of Radiology and Adjunct Professor of Health Services University of Washington, Harborview Medical Center Salary support: AHRQ grant
More informationThe Management of the Patient with an Acute Spinal Cord Injury D. J. Brown
The Management of the Patient 1 Associate Prof. Director Victorian Spinal Cord Service Austin Health Melbourne, Victoria, Australia 2 3 Continuity of care A prevention C triage / transfer U emergency /
More informationChapter 39 Trauma in the Elderly
Chapter 39 Trauma in the Elderly Episode Overview 1) 5 Risk Factors for falls in the elderly? 2) What anatomic and physiologic changes in the elderly patient are important for the management of trauma
More information3/3/2016. International Standards for the Neurologic Classification of Spinal Cord Injury (ISNCSCI)
International Standards for the Neurologic Classification of Spinal Cord Injury (ISNCSCI) American Spinal Injury Association International Spinal Cord Society Presented by Adam Stein, MD Chairman and Professor
More informationSpinal Trauma. General Rehabilitation of Patient with Spinal Trauma. Common Spinal Injuries. Important Anatomical Structures at each Vertebral Level
Asian Association for Dynamic Osteosynthesis Workshop on Management of Spinal Trauma 22 April 2007 (Sunday) Orthopaedic Learning Centre, PWH, Shatin, Hong Kong General Rehabilitation of Patient with Spinal
More informationSPECIFIC CATEGORIES OF INJURIES
Página 1 de 20 Copyright 2003 Lippincott Williams & Wilkins Hickey, Joanne V. Clinical Practice of Neurological & Neurosurgical Nursing, 5th Edition SPECIFIC CATEGORIES OF INJURIES Part of "Chapter 19
More information17. Imaging and interventional radiology
17. Imaging and interventional radiology These guidelines have been adapted from the Leeds Major Trauma Centre Imaging in Paediatric Major Trauma guidelines Written by Dr Annmarie Jeanes (Consultant Paediatric
More informationXXX Spinal Motion Restriction
Nor-Cal EMS Policy & Procedure Manual NAME OF MODULE XXX Purpose: The purpose of this protocol is to protect patients with signs and symptoms of spinal injuries and those who have the potential for spinal
More informationMedical evidence-based guidelines, when
TOPIC Introduction to the Guidelines for the Management of Acute Cervical Spine and Spinal Cord Injuries Mark N. Hadley, MD* Beverly C. Walters, MD, MSc, FRCSC *Co-Lead Author, Guidelines Author Group;
More informationCervical Spine in Baseball
Cervical Spine in Baseball Robert G Watkins, IV, MD Co-Director, Marina Spine Center Marina del Rey, CA Vice Chief of Staff Cedars-Marina del Rey Hospital Disclosures n Pioneer / RTI Consulting, Royalties
More informationObjectives. Comprehension of the common spine disorder
Objectives Comprehension of the common spine disorder Disc degeneration/hernia Spinal stenosis Common spinal deformity (Spondylolisthesis, Scoliosis) Osteoporotic fracture Destructive spinal lesions Anatomy
More informationChapter 26 Head and Spine Trauma The Nervous System The nervous system controls virtually all of our body activities including reflex, voluntary and
1 2 3 4 5 Chapter 26 Head and Spine Trauma The Nervous System The nervous system controls virtually all of our body activities including reflex, voluntary and involuntary activities Voluntary activities
More informationSpinal Cord Injury. North American Spine Society Public Education Series
Spinal Cord Injury North American Spine Society Public Education Series What Is a Spinal Cord Injury? A spinal cord injury is a condition that results from damage or trauma to the nerve tissue of the spine.
More informationA rare case of spinal injury: bilateral facet dislocation without fracture at the lumbosacral joint
J Orthop Sci (2012) 17:189 193 DOI 10.1007/s00776-011-0082-y CASE REPORT A rare case of spinal injury: bilateral facet dislocation without fracture at the lumbosacral joint Kei Shinohara Shigeru Soshi
More informationSpinal Cord Injury Transection Injury, Spinal Shock, and Hermiated Disc. Copyright 2014, 2011, 2006 by Saunders, an imprint of Elsevier, Inc.
Spinal Cord Injury Transection Injury, Spinal Shock, and Hermiated Disc 1 Spinal Cord Injury Results from fracture and/or dislocation of vertebrae // Compresses, stretches, or tears spinal cord Cervical
More informationMetastatic Spinal Disease
Metastatic Spinal Disease Mr Neil Chiverton Consultant Spinal Surgeon, Sheffield Objectives The scale and nature of the problem NICE recommendations Surgical decision making Case illustrations Incidence
More informationTHORACO-LUMBAR SPINE TRAUMA NORDIC TRAUMA COURSE 2016, AARHUS
THORACO-LUMBAR SPINE TRAUMA NORDIC TRAUMA COURSE 2016, AARHUS Ken F. Linnau, MD, MS Emergency Radiology Harborview Medical Center University of Washington Seattle, WA Thanks to Quynh T. Nguyen, MHS, PA-C
More informationEvaluation and Initial Management of Potential Traumatic Spinal Injuries
Evaluation and Initial Management of Potential Traumatic Spinal Injuries Reference Number: NHSCT/10/268 Responsible Directorate: Acute Hospital Services Replaces (if appropriate): N/A Policy Author/Team:
More informationESCOME Pre-Course Outline (v1.09)
ESCOME Pre-Course Outline (v1.09) 1. Basics of Spinal Disorders Introduction to Spinal Surgery Spinal Anatomy Introduction to Vertebral Anatomical Concepts Anatomy and Function of Joints and Ligaments
More informationRiver North Pain Management Consultants, S.C., Axel Vargas, M.D., Regional Anesthesiology and Interventional Pain Management.
River North Pain Management Consultants, S.C., Axel Vargas, M.D., Regional Anesthesiology and Interventional Pain Management. Chicago, Illinois, 60611 Phone: (888) 951-6471 Fax: (888) 961-6471 Clinical
More informationPre-hospital Trauma Life Support. Rattiya Banjungam Emergency Physician, Khon Kaen Hospital
Pre-hospital Trauma Life Support Rattiya Banjungam Emergency Physician, Khon Kaen Hospital Golden principles of Prehospital Trauma Care Golden Hour There is a golden hour if you are critically injured,
More information10O SPLINTING OF INJURIES ADULT & PEDIATRIC. 10Oa: Axial/Spine with Selective Spinal Motion Restriction Adult & Pediatric:
10O SPLINTING OF INJURIES ADULT & PEDIATRIC EMERGENCY MEDICAL RESPONDER EMT EMT-INTERMEDIATE 85 ADVANCED EMT PARAMEDIC 10Oa: Axial/Spine with Selective Spinal Motion Restriction Adult & Pediatric: Many
More informationACDF. Anterior Cervical Discectomy and Fusion. An introduction to
An introduction to ACDF Anterior Cervical Discectomy and Fusion This booklet provides general information on ACDF. It is not meant to replace any personal conversations that you might wish to have with
More informationComprehension of the common spine disorder.
Objectives Comprehension of the common spine disorder. Disc degeneration/hernia. Spinal stenosis. Common spinal deformity (Spondylolisthesis, Scoliosis). Osteoporotic fracture. Anatomy Anatomy Anatomy
More informationKey Primary CPT Codes: Refer to pages: 7-9 Last Review Date: October 2016 Medical Coverage Guideline Number:
National Imaging Associates, Inc. Clinical guidelines CERVICAL SPINE SURGERY: ANTERI CERVICAL DECOMPRESSION WITH FUSION CERVICAL POSTERI DECOMPRESSION WITH FUSION CERVICAL ARTIFICIAL DISC CERVICAL POSTERI
More informationISPUB.COM. Fracture Through the Body of the Axis. B Johnson, N Jayasekera CASE REPORT
ISPUB.COM The Internet Journal of Orthopedic Surgery Volume 8 Number 1 B Johnson, N Jayasekera Citation B Johnson, N Jayasekera.. The Internet Journal of Orthopedic Surgery. 2007 Volume 8 Number 1. Abstract
More informationSurgery. Conus medullaris and Cauda Equina Syndromes. Anatomy. See online here
Surgery Conus medullaris and Cauda Equina Syndromes See online here Conus medullaris and cauda equina syndromes are spinal cord injuries that involve injury to the lumbosacral segment of the spinal cord.
More informationEvaluation and Stabilization of the Athlete with Possible Spine Injury
Evaluation and Stabilization of the Athlete with Possible Spine Injury Jeffrey H. Bohmer, MD, FACEP Emergency Physician Northwestern Medicine Central DuPage Hospital June 12, 2015 Introduction Goals: 1.
More informationEpidemiology of Low back pain
Low Back Pain Definition Pain felt in your lower back may come from the spine, muscles, nerves, or other structures in that region. It may also radiate from other areas like the mid or upper back, a inguinal
More informationTrauma Life Support Pre-Hospital (TLS-P) Preparatory Materials
Trauma Life Support Pre-Hospital (TLS-P) Preparatory Materials 1 1. A high-risk bodily fluid for spreading infection is blood. 2. Items that can reduce the spread of infection include masks, gloves, and
More informationVERTEBRAL COLUMN ANATOMY IN CNS COURSE
VERTEBRAL COLUMN ANATOMY IN CNS COURSE Vertebral body Sections of the spine Atlas (C1) Axis (C2) What type of joint is formed between atlas and axis? Pivot joint What name is given to a fracture of both
More information1 Normal Anatomy and Variants
1 Normal Anatomy and Variants 1.1 Normal Anatomy MR Technique. e standard MR protocol for a routine evaluation of the spine always comprises imaging in sagittal and axial planes, while coronal images are
More informationClearing the C-spine in Obtunded Trauma Patients Based on Admission CT: A Prospective Randomized Tria l
Clearing the C-spine in Obtunded Trauma Patients Based on Admission CT: A Prospective Randomized Tria l Cervical Spine Research Society e-poster 45 December 3-5, 2015 Chris O Boynick MD, Tim Lonergan MD,
More informationCervical Spine Clearance in Australian Intensive Care Units
Original articles Cervical Spine Clearance in Australian Intensive Care Units D. LIEN, T. JACQUES, K. POWELL Intensive Care Unit, The St. George Hospital, Sydney, NEW SOUTH WALES ABSTRACT Objective: Rigid
More informationCervical Spine Precautions A quick review. By Joseph Lewis, M.D. Medical Director, Honolulu EMS Board Certified in Emergency Medicine
Cervical Spine Precautions A quick review By Joseph Lewis, M.D. Medical Director, Honolulu EMS Board Certified in Emergency Medicine 1 Goals of this Cervical Spine Immobilization In-service Learn Objectives:
More informationPRE-HOSPITAL PATIENT CARE PROTOCOLS BASIC LIFE SUPPORT/ADVANCED LIFE SUPPORT
PRE-HOSPITAL PATIENT CARE PROTOCOLS BASIC LIFE SUPPORT/ADVANCED LIFE SUPPORT Board Approved June 2007 Revised December 2009 Revised July 2011 Revised June 2015 435 Hunter Street Fredericksburg, VA 22401
More information